The purpose of this proposal is to secure sufficient funding to support a conference on the subject of peripheral neuropathy in diabetes. Diabetic peripheral neuropathy is a well-known long- term complication of diabetes mellitus. Its prevalence increases with the duration of the disease, reaching approximately 50% at 25 years. The precise etiology and pathophysiology of the disease is unknown, nor is there any preventive or cure. Symptoms range from a mild loss of peripheral sensory activity to total loss of limb sensation. Despite the prevalence and high morbidity of diabetic peripheral neuropathy, there is no widely accepted clinical approach for diagnosing its presence, nor is there a common system (including methodology) for grading the disorder. The lack of a standard approach to diagnosis and staging has made it extremely difficult to compare published research data, to perform well designed epidemiological studies, or to determine the efficacy of clinical intervention trails. The purpose of the proposed conference will be: (1) to develop criteria, utilizing the appropriate technology, for determining the presence and degree of the neuropathic disorder in diabetic persons without clinically evident somatic or autonomic polyneuropathy, and (2) to propose a system and methodology that grades in a sensitive, practical, and reproducible fashion the improvement or worsening of clinically evident distal, symmetrical, somatic or autonomic polyneuropathy of diabetes. The format of the conference will be to convene a panel of expert neurologists and diabetologists who will participate in two days of discussion sessions presented by invited speakers. The panel will, at the time of the conference, develop a position paper that addresses the two objectives of the meeting. The resulting paper will be published in Diabetes Care and in Neurology. Publication of the conference position paper in these journals will undoubtedly improve the ability of investigators and clinicians to accurately diagnose and treat peripheral neuropathy. There has been no previous conference of this scope.